Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Association between diffuse myocardial fibrosis and diastolic dysfunction in sickle cell anemia
source: Blood
year: 2017
authors: Niss O, Fleck R, Makue F, Alsaied T, Desai P, Towbin JA, Malik P, Taylor MD, Quinn CT
summary/abstract:Sickle cell anemia (SCA)-related cardiomyopathy is characterized by diastolic dysfunction and hyperdynamic features. Diastolic dysfunction portends early mortality in SCA. Diastolic dysfunction is associated with microscopic myocardial fibrosis in SCA mice, but the cause of diastolic dysfunction in humans with SCA is unknown. We used cardiac magnetic resonance measurements of extracellular volume fraction (ECV) to discover and quantify diffuse myocardial fibrosis in 25 individuals with SCA (mean age, 23 ± 13 years) and determine the association between diffuse myocardial fibrosis and diastolic dysfunction. ECV was calculated from pre- and post-gadolinium T1 measurements of blood and myocardium, and diastolic function was assessed by echocardiography. ECV was markedly increased in all participants compared with controls (0.44 ± 0.08 vs 0.26 ± 0.02, P < .0001), indicating the presence of diffuse myocardial fibrosis. Seventeen patients (71%) had diastolic abnormalities, and 7 patients (29%) met the definition of diastolic dysfunction. Participants with diastolic dysfunction had higher ECV (0.49 ± 0.07 vs 0.37 ± 0.04, P = .01) and N-terminal pro-brain natriuretic peptide (NT-proBNP; 191 ± 261 vs 33 ± 33 pg/mL, P = .04) but lower hemoglobin (8.4 ± 0.3 vs 10.9 ± 1.4 g/dL, P = .004) compared with participants with normal diastolic function. Participants with the highest ECV values (≥0.40) were more likely to have diastolic dysfunction (P = .003) and increased left atrial volume (57 ± 11 vs 46 ± 12 mL/m2, P = .04) compared with those with ECV <0.4. ECV correlated with hemoglobin (r = -0.46, P = .03) and NT-proBNP (r = 0.62, P = .001). In conclusion, diffuse myocardial fibrosis, determined by ECV, is a common and previously underappreciated feature of SCA that is associated with diastolic dysfunction, anemia, and high NT-proBNP. Diffuse myocardial fibrosis is a novel mechanism that appears to underlie diastolic dysfunction in SCA
organization: Cincinnati Children's Hospital Medical Center; The Ohio State University; Le Bonheur Children's Hospital, MemphisDOI: 10.1182/blood-2017-02-767624
read more full text
Related Content
-
Management of male fertility in sickle cell disease before and after hydroxycarbamideHydroxycarbamide (hydroxyurea or HU) is ...
-
Sickle Cell Carriers’ Unmet Information Needs: Beyond Knowing Trait StatusBenefits of identifying sickle cell dise...
-
Black Americans With Sickle Cell Trait At Increased Risk Of Kidney DiseaseAfrican Americans with sickle cell trait...
-
SCA Therapy Hydroxyurea Doesn’t Boost Malaria Risk in Sub-Saharan Africa, Study FindsHydroxyurea, a treatment recommended for...
-
Small chips, big impact: MSU researcher studies cardiovascular, sickle cell diseaseA Mississippi State University researche...
-
Safety and early hints of benefit seen in phase 1b trial of PF-04447943Sickle cell disease (SCD) patients were ...
-
Hospitals See No Link Between US Opioid Crisis and Patients’ Use of Treatment, Study ReportsThe U.S. opioid epidemic is not linked t...
To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.